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Knowledge and Practice Regarding Diarrheal Diseases and Drinking Water Usage in Kanyakumari District, South India

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Knowledge and Practice Regarding Diarrheal Diseases and Drinking Water Usage in Kanyakumari District, South India National Journal of Research in Community Medicine. Vol.6. Issue 3. Jul.-Sep.-2017(217-222) ISSN - Print: 2277 – 1522, Online: 2277 – 3517 Original Research Article Knowledge and practice regarding Diarrheal Diseases and Drinking Water Usage in Kanyakumari district, South India. Sudhir Ben Nelson1*, Priya R Panicker2, Lakshmi Nandakumar3, Krishnaveni Malaichamy3 Date of Submission: 18.05.2017 Date of Acceptance: 07.07.2017 Authors: Corresponding Author: 1. Assistant Professor, 2. Junior Resident, &3. Intern, Dr. Sudhir Ben Nelson Department of Community Medicine, Sree Assistant Professor, Department of Community Mookambika Institute of Medical Sciences, Medicine, Sree Mookambika Institute of Kulasekaram, Tamilnadu, India. Medical Sciences, Kulasekaram, Tamilnadu, India. Pin: 629001 Email: [email protected] Abstract Introduction: Acute diarrheal diseases account for about 8% of deaths among under 5 children in India. Approximately 88% of diarrheal diseases are attributed to unsafe water supply, inadequate sanitation and hygiene. Proper knowledge about diarrhea and its prevention is essential for the people to practice adequate control measures. Proper water usage and handling practice also play an important role in control of diarrheal / water borne diseases. Objectives: to assess 1) knowledge and practice regarding diarrheal diseases and 2) the drinking water practices among the population of Arumanai panchayat of Kanyakumari district in South India. Material & Methods: A cross sectional study was done among households of Arumanai panchayat of Kanyakumari district between September and November 2015. 150 households that have been residing in the area for > 6 months were included. Data was collected using a pretested semi- structured questionnaire Results: Among the respondents, 26.7% (40) believed microorganisms to be a cause of diarrhea, while88% believed that boiling renders the water safe for drinking purposes. Only 50.7% had prepared Oral Rehydration Solution (ORS) during the last episode of Diarrhea. 40.7% of the respondents washed their hands with soap and water before eating food and only 24% did it after defecation. Half of the households used covered well as their source of drinking water & 97.3% had a toilet at home. 86% boil water used for drinking purposes but only 27.3% boil water for 10 minutes. 44% household do not clean their well frequently & 20.7% use chlorination. Conclusions: The degree of knowledge and practice regarding diarrheal diseases and the drinking water practices was found to be inconsistent. The knowledge and use of ORS is better than what is seen in many studies done in India. The community needs further Behaviour change communication including training on proper treatment of water. Keywords: Diarrhea, ORS, Hand Hygiene, Drinking water, Boiling deaths worldwide. More than 80 percent of these deaths occur in sub-Saharan Africa and South Asia.1 INTRODUCTION In India, acute diarrheal diseases accounts for about 8% Diarrhea and water borne diseases are the leading cause of deaths in under 5 years age group. During the year of mortality and morbidity in developing countries.1Acute 2011, about 10.6 million cases with 1,293 deaths were diarrhea is rivalled in importance only by respiratory reported in India.4 India also has the highest estimates of infection, as a cause of morbidity on a worldwide scale. under 5 mortality due to diarrhea in the world.1 Despite When the WHO initiated the Diarrheal Diseases Control the success of various national programs like Universal Programme in 1980, approximately 4.6 million children Immunization Program, Child Survival and Safe used to die each year due to dehydration caused by Motherhood (CSSM), Reproductive and Child Health diarrhea.2Diarrhea is still a major killer of children under (RCH), Integrated Management of Neonatal and 5 years, although its toll has dropped by a third over the Childhood Illnesses (IMNCI) and Reproductive, past decade, from 1.2 million deaths in 2000 to 0.7 Maternal, Neonatal, Adolescent and Child Health million in 2011.3It now causes about 11 percent of child 217 Diarrheal Diseases and Drinking Water Usage. Sudhir Ben Nelson et.al. Click here for more articles: www.commedjournal.in National Journal of Research in Community Medicine. Vol.6. Issue 3. Jul.-Sep.-2017(217-222) ISSN - Print: 2277 – 1522, Online: 2277 – 3517 programmes (RMNCH+A), the proportional mortality practices that need special focus. It will also help in rate of diarrhea in India still remains high.5 finding out any other health or public work actions required in the community. Hence this study was Diarrhea is also a leading cause of death during conducted to assess knowledge and practice regarding emergencies and natural disasters. Displacement of diarrheal diseases and the drinking water practices among population into temporary overcrowded shelters is often the population of Arumanai panchayat of Kanyakumari associated with polluted water sources, inadequate district in South India. sanitation, poor food hygiene practices and malnutrition- all of which affect the spread and severity of diarrhea.4 MATERIAL AND METHODS Safe drinking water has been recognized as a basic Study setting: Kanyakumari district in the state of element of ‘Primary health care’ by the World Health Tamilnadu, is the southernmost district of mainland India. Assembly as part of ‘Health for All by 2000’.4 Water In receives significant rainfall during both monsoon intended for human consumption should be both safe and seasons of India and is comparatively rich in water wholesome and in adequate amounts for fulfilling the resources. Arumanai Panchayat of Kanyakumari district is requirements of a family or a community. This has been a town panchayat with a population of 16,283 coming defined as water that is -free from pathogenic agents, free from 4,236households. The overall Literacy rate is from harmful chemical substances, pleasant to the taste, 90.5%.9A cross sectional study was conducted among the i.e., free from color and odour; and usable for domestic population of Arumanai Panchayat for a period of 2 purposes.4 months from September to November 2015. Water is said to be polluted or contaminated when it does Sampling: A pilot testing of the questionnaire was done not fulfill the above criteria. Water pollution is a growing among the households and proportion of households with hazard in many developing countries owing to overuse, one episode of diarrhea in past 5 years was obtained as decreased groundwater reserves and irresponsible human 55%. Sample size of 145 houses was arrived at using the activity. Without ample and safe drinking water, basic formula n=4pq/d2, where the above proportion is health care services cannot be provided to the community. considered as p, q= 1-p and d is the permissible error (taken as 15% of p). This was rounded off to 150 samples. Approximately 88% of diarrheal diseases are attributed to The sample households were selected from the panchayat 6 unsafe water supply, inadequate sanitation and hygiene. household list. Arumanai panchayat has 15 separate Water sources and sanitation facilities have an important locations/villages. 10 households were selected from each influence on the health of household members, especially area by simple random sampling. children.7 Unsafe drinking water is a major problem, especially in rural areas. Even when a drinking water Inclusion criteria: Households whose residents have supply is provided, unhygienic water handling practices been residing in the study area for more than 6 months result in contamination and thereby produce diarrheal and had a respondent aged more than 18 years at the time diseases, especially in the vulnerable groups of children of data collection were included in the study. Exclusion and the elderly. Personal hygiene especially hand washing criteria: Households where the available adult is the most important factor in preventing diarrheal respondent could not answer questions coherently were disease transmission. Lack of toilets and the practice of excluded from the study. open air defecation in rural areas also cause illness & death among children.8 Data collection: Data was collected using a pretested semi-structured questionnaire administered to the The methods taken to prevent diarrheal diseases are respondents in the local language after obtaining informed mainly focused at the household level. Thus without written consent. It contained questions on basic proper action by the family diarrheal diseases cannot be characteristics of the respondents, knowledge about cause brought under control. There are several misconceptions of Diarrheal diseases, perceptions about diarrheal and varied perceptions about diarrheal diseases among lay diseases& actions taken when somebody has diarrhea. people, especially in villages. Proper knowledge about Questions on Oral Rehydration Solution (ORS) & Hand diarrhea and its prevention is essential for the people to hygiene were included. Details about the drinking water practice adequate control measures. Water usage and sources, human waste disposal, water storage & handling, handling practice also play an important role in knowledge about water contamination & its prevention, transmission of diarrheal / water borne diseases. A study actions taken to purify the water were also asked. If the incorporating both these aspects is still relevant in any selected household could not be included in the study, the state of India. Information from the community will help adjacent
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